Joint pain

Question 1

Septic arthritis

Answer 1

A
B
C
iv fluids
vbg
broad spectrum abs
paracetamol

D

En - erythema
effusion
does it feel warm
any neurovascuar compromise
palpate the distal pulses

Question 2

Mx of septic arthritis ?

Answer 2

joint aspiration and wash out

intravenous antibiotics which cover Gram-positive cocci are indicated. The BNF currently recommends flucloxacillin or clindamycin if penicillin allergic

arthroscopic lavage may be required

Question 3

gout / pseudo gout / septic arthritis would are the findings in microscope ?

Answer 3

Gout would be associated with urate crystals which appear under polarised light microscopy as strongly negatively birefringent needle-shaped crystals.

Pseudogout in contrast is caused by calcium pyrophosphate crystals which appear as positively birefringent rhomboid-shaped crystals.

Thick, turbid, blood-stained fluid. Presence of gram positive cocci”

Question 4

septic arthritis cause ?

Answer 4

Staphylococcus aureus
in young adults who are sexually active, Neisseria gonorrhoeae is the most common organism (disseminated gonococcal infection)

most common route of infection is via haematogenous spread,